EFFECT OF A SINGLE DOSE OF LIDOCAINE AND KETAMINE ON INTRAOPERATIVE OPIOIDS REQUIREMENTS IN PATIENTS UNDERGOING ELECTIVE ABDOMINAL SURGERY UNDER GENERAL ANESTHESIA: A RETROSPECTIVE COHORT STUDY

Abstract

Background: Improving postoperative recovery, minimizing opioid related complications, and reducing perioperative opioid exposure are major goals of contemporary pain management in abdominal surgery. Although opioids remain a cornerstone of intraoperative analgesia, their use is associated with several adverse outcomes, including respiratory depression, postoperative nausea and vomiting (PONV), delayed gastrointestinal recovery, opioid induced hyperalgesia (OIH), and risk of prolonged opioid dependence. Intravenous lidocaine or ketamine have been increasingly incorporated into multimodal analgesia protocols because of their analgesic, antiinflammatory, and opioid sparing properties. However, evidence regarding the effectiveness of a single intravenous dose of these agents remains limited, particularly in real world clinical settings and in underrepresented populations such as hospitals in the Northern West Bank.